In a nutshell
This study examined treatment outcomes of anti-VEGF for diabetic macular edema. Researchers reported improved vision based on both physical examinations and patient-reported outcomes 12 months after treatment.
Some background
Chronic high blood glucose levels can result in damage to small blood vessels. This can lead to a number of blood vessel-related complications. Diabetic macular edema occurs when blood vessels at the back of the eye become damaged and swollen. This can result in complete vision loss if severe. It has been estimated that most patients with type 1 diabetes and more than half of the patients with type 2 diabetes will develop some degree of vision impairment. Early diagnosis and treatment can reduce the risk of blindness.
Anti-vascular endothelial growth factor (anti-VEGF), such as ranibizumab (Lucentis), is a type of treatment that blocks a protein involved in blood vessel formation. It is administered by injection directly into the eye. Anti-VEGF treatment has been found to stabilize and even improve vision in patients with diabetic macular edema. More long-term data is needed on the effectiveness of anti-VEGF from both patients and physicians.
Methods & findings
The aim of this study was to examine the treatment outcomes of anti-VEGF based on physical examinations as well as patient-reported outcomes.
58 patients with type 1 or type 2 diabetes were included in this study. All patients had visual impairment due to diabetic macular edema and were treated with ranibizumab. Patients initially received 3 injections per month and then once a month, as required. Visual acuity was measured by the ability to read letters from a distance. Eye exams and blood tests were also carried out. Patients completed questionnaires to record changes in vision and general health.
Before treatment, the average number of letters patients could read from a distance of 2 meters was 65. Visual acuity was significantly improved at 4 months and remained improved at 12 months after treatment (average 70.2 letters).
Average retinal thickness was significantly decreased at 12 months (indicating a reduction in swelling). HbA1c levels (an average measure of blood glucose over 3 months) were also significantly reduced. Changes in visual acuity scores could be explained by the change in HbA1c levels.
Patients reported significant improvements in general health, general vision, as well as near and distance activities after 12 months of treatment. This self-reported improvement was more pronounced for patients who also showed improvements in visual acuity.
The bottom line
Researchers concluded that anti-VEGF treatment can improve visual acuity, retinal thickness, and patient-reported outcomes at 12 months.
The fine print
Larger studies are needed to confirm these results.
Published By :
Diabetes Research and Clinical Practice
Date :
Sep 21, 2016
